School board agrees to pursue plan for more nurses

Over the next several years, Sarasota County Schools will phase in more on-site LPNs and RNs to care for students’ medical needs.

For 10 years, health administrators for Sarasota County Schools have been trying to decide how best to serve students’ medical needs.

And, according to Sarasota School Health Services Supervisor Suzanne Dubose, the school district has not recently kept up with demand.

In the 2017-2018 school year, 64% of district students reported some variety of “health condition,’’ and 9% of them required some kind of regular administration of medication or medical procedure. Ten years ago, those numbers were 41% and 7%.

What “complex needs” do school nurses help students meet?

Insulin injections

Catheter care

Tube-feedings

Epinephrine and narcotics administration

Suctioning

Mental health first aid

And more

As demand increased, health services staff had to rethink its approach to supply. Enter SHINES: Dubose’s proposal for a new school health services delivery model, which the school board agreed to pursue earlier this month in a workshop.

The objective of SHINES, or School Health Is Needed in Every School, is “to place a registered nurse or licensed practical nurse in every Sarasota County District school.”

Dubose’s proposal outlined a plan that, through attrition, would gradually employ more school-based LPNs with a nod toward keeping students in class.

“Attendance is an issue. If you’re not there, how do you learn?” Dubose said. “Health is a huge component of [attendance].”

Sarasota County has 10 registered nurses, two licensed practical nurses and 40 health aides on campuses.

Dubose’s concern stems from the narrower range of duties health aides are permitted to perform. For instance, they are not permitted to diagnose, assign a care plan or administer insulin without supervision from an RN.

“We don’t typically have a full-time nurse in every school. For the most part, they’re traveling between schools. Sometime’s it’s two. Sometimes it’s four,” Dubose said. “And when a nurse has to call out, that’s when we need to figure out who is going to cover. And sometimes it’s me.”

Sometimes, demand can be high.

“ I know at Sarasota High, for example, that on a Monday morning when that RN comes to work, there would be a very long line waiting to see her outside of her door,” School Board Chair Jane Goodwin said. “There are some chronic health issues that our children are not having addressed any other way other than with the school nurse.”

In addressing the SHINES proposal, Superintendent Todd Bowden assured board members at the January workshop that the plan would not actually add any new positions during the 2019-2020 academic year. Nor would it cut any existing positions. Instead, health aides would be replaced by LPNs through attrition, which makes a rollout timeline hard to pin down.

Ultimately, Sarasota County students will be overseen by nine RNs, 23 LPNs and 24 health room aides.

Additionally, rather than having RNs who “float” between two to four schools at time, the new staff model will involve making at least one RN available at every middle and high school at a time. Those RNs would oversee the LPNs, one of whom would be placed at every elementary school.

As per Dubose’s proposal, the new staff arrangement would raise the current salary expenditures from $2,108,482 to $2,348,221, not including the cost of the staff supervisors. It costs $5,400 more per position to hire a LPN instead of a health aide.

Board members Shirley Brown and Caroline Zucker voiced approval for the proposal, affirming that they felt the plan was cost-effective and wouldn’t require one large monetary hit to the district’s budget at one time.

“I have always loved the idea of this program,” Goodwin said. “You cannot learn if you are sick. You cannot learn if you are hungry. And we need to help.”